Glen Ray Hanson, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18843 Issued in OK

Practice address

3315 Kethley Rd
Shawnee, OK 74804-9638

Phone

(405) 273-5801

Fax

(405) 878-3814

NPI assigned

Jun 7, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Oklahoma College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SSM Health St Anthony Hospital - Shawnee Hospital, Shawnee, OK, CCN 370149
• Oklahoma Heart Hospital South, LLC Hospital, Oklahoma City, OK, CCN 370234

Merit-based Incentive Payment System (MIPS)

Final score

84.48 of 100Reported as group

Quality

81.18

Promoting interoperability

93

Improvement activities

40

Cost

72.93

Merit-based Incentive Payment System (MIPS)

Final score

85.96 of 100Reported as group

Quality

80.43

Promoting interoperability

100

Improvement activities

40

Cost

72.76

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ghanson165621@direct-ehr-ssmhc.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saints Medical Group, LLC

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1437195922
  Medicare reassignment Care Compare group NPD
• SSM Health Care of Oklahoma, Inc

  • Certified Registered Nurse Anesthetist
  • Oklahoma City, OK
  • NPI 1033283932
  Medicare reassignment NPD
• Saints Medical Group, LLC

  • Durable Medical Equipment & Medical Supplies
  • Edmond, OK
  • NPI 1730907700
  NPD
• SSM Health Care of Oklahoma Inc

  • Community/Retail Pharmacy
  • Oklahoma City, OK
  • NPI 1649602293
  NPD
• SSM Health Care of Oklahoma, Inc.

  • Family Medicine Physician
  • Oklahoma City, OK
  • NPI 1487677456
  NPD
• St Anthony Shawnee Hospital Inc

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Oklahoma Heart Hospital South LLC

  • General Acute Care Hospital
  • Oklahoma City, OK
  • NPI 1841442274
  Care Compare affiliation
• St Anthony Shawnee Hospital Inc

  • General Acute Care Hospital
  • Shawnee, OK
  • NPI 1134123193
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1497795652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 849",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748020849",
            "telephone_number": "405-273-5801",
            "fax_number": "405-878-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3315 KETHLEY RD",
            "city": "SHAWNEE",
            "state": "OK",
            "postal_code": "748049638",
            "telephone_number": "405-273-5801",
            "fax_number": "405-878-3814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "GLEN",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OK",
            "license": "18843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100094710A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candice Hamre, MSN, APRN, FNP-C
• Stephanie M Hancock, P.A-C
• Hannah K Handy
• Dana Gayle Hanebutt, NP
• Tracy Duane Haney, B.S.
• Terrie Jo Hanson, PA-C
• Harmony Counseling, PLLC
• Baylee Harris
• Kelli Harris
• Shaya Leigh Harris

• Surgery Physician in Shawnee, OK
• Providers in Shawnee, OK by specialty
• Surgery Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.